Combined transtemporal access for large (>3 cm) meningiomas of the cerebellopontine angle
Large meningiomas of the cerebellopontine angle present a formidable surgical challenge due to tumor vascularity, neural attachment, and brain stem compression. The purpose of this paper is to present our use of the combined transtemporal approach in the surgical treatment of 29 large meningiomas. T...
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| Veröffentlicht in: | Otolaryngology-head and neck surgery 2006-06, Vol.134 (6), p.949-952 |
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| creator | Leonetti, John P. Anderson, Douglas E. Marzo, Sam J. Origitano, Thomas C. Schuman, Rita |
| description | Large meningiomas of the cerebellopontine angle present a formidable surgical challenge due to tumor vascularity, neural attachment, and brain stem compression. The purpose of this paper is to present our use of the combined transtemporal approach in the surgical treatment of 29 large meningiomas.
Twenty-nine patients with large meningiomas of the CPA were surgically treated through a combined retrosigmoid-transpetrosal-transcochlear approach at our tertiary care academic medical center from July 1995 through July 2004. Data was collected from a retrospective medical records review.
Total tumor removal was achieved in 19 of 29 (67%) of the patients and the facial nerve was anatomically preserved in 26 of 29 (89%) of the cases. Cerebrospinal fluid leakage was seen in 3.5% of the patients and additional transient cranial nerve deficits were noted in 14% of the cases, but no significant neurologic sequelae occurred. Of the 10 patients with residual tumor, 6 have been stable without growth, 2 were treated with reoperation for regrowth of disease, and 2 were controlled with localized radiotherapy.
This combined lateral transtemporal approach provided wide exposure to the cerebellopontine angle and optimized the surgical extirpation of 29 large meningiomas presented in this series.
EBM rating: C-4 |
| doi_str_mv | 10.1016/j.otohns.2005.12.017 |
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Twenty-nine patients with large meningiomas of the CPA were surgically treated through a combined retrosigmoid-transpetrosal-transcochlear approach at our tertiary care academic medical center from July 1995 through July 2004. Data was collected from a retrospective medical records review.
Total tumor removal was achieved in 19 of 29 (67%) of the patients and the facial nerve was anatomically preserved in 26 of 29 (89%) of the cases. Cerebrospinal fluid leakage was seen in 3.5% of the patients and additional transient cranial nerve deficits were noted in 14% of the cases, but no significant neurologic sequelae occurred. Of the 10 patients with residual tumor, 6 have been stable without growth, 2 were treated with reoperation for regrowth of disease, and 2 were controlled with localized radiotherapy.
This combined lateral transtemporal approach provided wide exposure to the cerebellopontine angle and optimized the surgical extirpation of 29 large meningiomas presented in this series.
EBM rating: C-4</description><identifier>ISSN: 0194-5998</identifier><identifier>EISSN: 1097-6817</identifier><identifier>DOI: 10.1016/j.otohns.2005.12.017</identifier><identifier>PMID: 16730536</identifier><language>eng</language><publisher>Los Angeles, CA: Mosby, Inc</publisher><subject>Adult ; Aged ; Cerebellar Neoplasms - diagnostic imaging ; Cerebellar Neoplasms - pathology ; Cerebellar Neoplasms - surgery ; Cerebellopontine Angle - diagnostic imaging ; Cerebellopontine Angle - pathology ; Cerebellopontine Angle - surgery ; Cerebral Angiography ; Facial Nerve ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Meningioma - diagnostic imaging ; Meningioma - pathology ; Meningioma - surgery ; Middle Aged ; Otologic Surgical Procedures ; Retrospective Studies ; Temporal Bone - surgery ; Treatment Outcome</subject><ispartof>Otolaryngology-head and neck surgery, 2006-06, Vol.134 (6), p.949-952</ispartof><rights>2006 American Academy of Otolaryngology–Head and Neck Surgery Foundation.</rights><rights>2006 SAGE Publications</rights><rights>2006 American Association of Otolaryngology‐Head and Neck Surgery Foundation (AAO‐HNSF)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5670-6dc7d1d133ed5574a099dab92be33881c7c356c04f6dd66180d9187454af3f003</citedby><cites>FETCH-LOGICAL-c5670-6dc7d1d133ed5574a099dab92be33881c7c356c04f6dd66180d9187454af3f003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1016/j.otohns.2005.12.017$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1016/j.otohns.2005.12.017$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,1417,21819,27924,27925,43621,43622,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16730536$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leonetti, John P.</creatorcontrib><creatorcontrib>Anderson, Douglas E.</creatorcontrib><creatorcontrib>Marzo, Sam J.</creatorcontrib><creatorcontrib>Origitano, Thomas C.</creatorcontrib><creatorcontrib>Schuman, Rita</creatorcontrib><title>Combined transtemporal access for large (>3 cm) meningiomas of the cerebellopontine angle</title><title>Otolaryngology-head and neck surgery</title><addtitle>Otolaryngol Head Neck Surg</addtitle><description>Large meningiomas of the cerebellopontine angle present a formidable surgical challenge due to tumor vascularity, neural attachment, and brain stem compression. The purpose of this paper is to present our use of the combined transtemporal approach in the surgical treatment of 29 large meningiomas.
Twenty-nine patients with large meningiomas of the CPA were surgically treated through a combined retrosigmoid-transpetrosal-transcochlear approach at our tertiary care academic medical center from July 1995 through July 2004. Data was collected from a retrospective medical records review.
Total tumor removal was achieved in 19 of 29 (67%) of the patients and the facial nerve was anatomically preserved in 26 of 29 (89%) of the cases. Cerebrospinal fluid leakage was seen in 3.5% of the patients and additional transient cranial nerve deficits were noted in 14% of the cases, but no significant neurologic sequelae occurred. Of the 10 patients with residual tumor, 6 have been stable without growth, 2 were treated with reoperation for regrowth of disease, and 2 were controlled with localized radiotherapy.
This combined lateral transtemporal approach provided wide exposure to the cerebellopontine angle and optimized the surgical extirpation of 29 large meningiomas presented in this series.
EBM rating: C-4</description><subject>Adult</subject><subject>Aged</subject><subject>Cerebellar Neoplasms - diagnostic imaging</subject><subject>Cerebellar Neoplasms - pathology</subject><subject>Cerebellar Neoplasms - surgery</subject><subject>Cerebellopontine Angle - diagnostic imaging</subject><subject>Cerebellopontine Angle - pathology</subject><subject>Cerebellopontine Angle - surgery</subject><subject>Cerebral Angiography</subject><subject>Facial Nerve</subject><subject>Female</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Meningioma - diagnostic imaging</subject><subject>Meningioma - pathology</subject><subject>Meningioma - surgery</subject><subject>Middle Aged</subject><subject>Otologic Surgical Procedures</subject><subject>Retrospective Studies</subject><subject>Temporal Bone - surgery</subject><subject>Treatment Outcome</subject><issn>0194-5998</issn><issn>1097-6817</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMFu1DAURS0EotPCHyDkFYJFhvfixE4kVKmMWopU0Q0sWFmO_TL1KLEHOwPq35NRRmIHrO7m3qOrw9grhDUCyve7dZziQ8jrEqBeY7kGVE_YCqFVhWxQPWUrwLYq6rZtzth5zjsAkFKp5-wMpRJQC7li3zdx7Hwgx6dkQp5o3MdkBm6spZx5HxMfTNoSf3spuB3f8ZGCD1sfR5N57Pn0QNxSoo6GIe5jmGYWN2E70Av2rDdDppenvGDfbq6_bm6Lu_tPnzdXd4WtpYJCOqscOhSCXF2rykDbOtO1ZUdCNA1aZUUtLVS9dE5KbMC12KiqrkwvegBxwd4s3H2KPw6UJz36bOc7JlA8ZC0bKLFGnIvVUrQp5pyo1_vkR5MeNYI-KtU7vSjVR6UaSz0rnWevT_xDN5L7Mzo5nAsflsIvP9Djf0H1_e2XjzclCHn8j8s8my3pXTykMOv616fLZUOz2J-eks7WU7DkfCI7aRf93wG_Af4grEU</recordid><startdate>200606</startdate><enddate>200606</enddate><creator>Leonetti, John P.</creator><creator>Anderson, Douglas E.</creator><creator>Marzo, Sam J.</creator><creator>Origitano, Thomas C.</creator><creator>Schuman, Rita</creator><general>Mosby, Inc</general><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>200606</creationdate><title>Combined transtemporal access for large (>3 cm) meningiomas of the cerebellopontine angle</title><author>Leonetti, John P. ; Anderson, Douglas E. ; Marzo, Sam J. ; Origitano, Thomas C. ; Schuman, Rita</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5670-6dc7d1d133ed5574a099dab92be33881c7c356c04f6dd66180d9187454af3f003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cerebellar Neoplasms - diagnostic imaging</topic><topic>Cerebellar Neoplasms - pathology</topic><topic>Cerebellar Neoplasms - surgery</topic><topic>Cerebellopontine Angle - diagnostic imaging</topic><topic>Cerebellopontine Angle - pathology</topic><topic>Cerebellopontine Angle - surgery</topic><topic>Cerebral Angiography</topic><topic>Facial Nerve</topic><topic>Female</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Meningioma - diagnostic imaging</topic><topic>Meningioma - pathology</topic><topic>Meningioma - surgery</topic><topic>Middle Aged</topic><topic>Otologic Surgical Procedures</topic><topic>Retrospective Studies</topic><topic>Temporal Bone - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leonetti, John P.</creatorcontrib><creatorcontrib>Anderson, Douglas E.</creatorcontrib><creatorcontrib>Marzo, Sam J.</creatorcontrib><creatorcontrib>Origitano, Thomas C.</creatorcontrib><creatorcontrib>Schuman, Rita</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>Otolaryngology-head and neck surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leonetti, John P.</au><au>Anderson, Douglas E.</au><au>Marzo, Sam J.</au><au>Origitano, Thomas C.</au><au>Schuman, Rita</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Combined transtemporal access for large (>3 cm) meningiomas of the cerebellopontine angle</atitle><jtitle>Otolaryngology-head and neck surgery</jtitle><addtitle>Otolaryngol Head Neck Surg</addtitle><date>2006-06</date><risdate>2006</risdate><volume>134</volume><issue>6</issue><spage>949</spage><epage>952</epage><pages>949-952</pages><issn>0194-5998</issn><eissn>1097-6817</eissn><abstract>Large meningiomas of the cerebellopontine angle present a formidable surgical challenge due to tumor vascularity, neural attachment, and brain stem compression. The purpose of this paper is to present our use of the combined transtemporal approach in the surgical treatment of 29 large meningiomas.
Twenty-nine patients with large meningiomas of the CPA were surgically treated through a combined retrosigmoid-transpetrosal-transcochlear approach at our tertiary care academic medical center from July 1995 through July 2004. Data was collected from a retrospective medical records review.
Total tumor removal was achieved in 19 of 29 (67%) of the patients and the facial nerve was anatomically preserved in 26 of 29 (89%) of the cases. Cerebrospinal fluid leakage was seen in 3.5% of the patients and additional transient cranial nerve deficits were noted in 14% of the cases, but no significant neurologic sequelae occurred. Of the 10 patients with residual tumor, 6 have been stable without growth, 2 were treated with reoperation for regrowth of disease, and 2 were controlled with localized radiotherapy.
This combined lateral transtemporal approach provided wide exposure to the cerebellopontine angle and optimized the surgical extirpation of 29 large meningiomas presented in this series.
EBM rating: C-4</abstract><cop>Los Angeles, CA</cop><pub>Mosby, Inc</pub><pmid>16730536</pmid><doi>10.1016/j.otohns.2005.12.017</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library - AutoHoldings Journals; MEDLINE; SAGE Journals; Alma/SFX Local Collection |
| subjects | Adult Aged Cerebellar Neoplasms - diagnostic imaging Cerebellar Neoplasms - pathology Cerebellar Neoplasms - surgery Cerebellopontine Angle - diagnostic imaging Cerebellopontine Angle - pathology Cerebellopontine Angle - surgery Cerebral Angiography Facial Nerve Female Humans Magnetic Resonance Imaging Male Meningioma - diagnostic imaging Meningioma - pathology Meningioma - surgery Middle Aged Otologic Surgical Procedures Retrospective Studies Temporal Bone - surgery Treatment Outcome |
| title | Combined transtemporal access for large (>3 cm) meningiomas of the cerebellopontine angle |
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